T Nation

My TRT Journey Starts Now


#62

I think there is some truth to that in a lot of Doctors, but I would definitely not trust this as a blanket statement. There are regular doctors out there that KNOW that low levels of T can lead to other very serious health problems over time, and that it is more than likely the cause of the problems you’re bringing to him/her, but they refuse to treat it. They are in the pocket of an insurance company and won’t do anything unless the blood tests come back as “clinically” low, on at least 3 tests, and even then it’s hit and miss as to whether you’ll get a protocol that doesn’t send you into a tail spin.

I say that if they REALLY care so much about the well being of their older male patients, then they owe it to themselves and those patients to be as informed as possible about TRT. If I care about someone and want to help them, I’m going to research the cutting edge of the technology to make sure that I am treating them in the best way I possibly could.

I think that if a doctor has the authority to prescribe medication for any treatment, then that doctor has the responsibility to be as much of an expert, in the field they are prescribing in, as possible.

I think some of these docs are just as much dope pushers as some of the quirky online TRT clinics. The only difference, in my mind, is that the pcp is the middle man, and the insurance company is the source. The online clinics are like going directly to the source.


#63

Thanks so much and will keep you posted. You guys are the best. Last question - subq or IM? He left that up to me.


#64

That’s really preference when you start. If you find that even with moderate doses IM gives you noticeable spikes in E2, or causes you any otherwise unpleasant feelings, then SubQ might be a better option for you.


#65

Just read some things anecdotally about some impact on T and E2. Seems easier for me as I already SubQ inject Enbrel but didn’t know if one is preferred.


#66

Right I agree. These clinics don’t even call the client and have a discussion on their issues. It’s a ducked up thing. It better not hurt other men who really need help.


#67

I think what your doing is smart. With a higher shbg you might need tot ale a higher dosage and 100 might not do anything for you. I would start on 120.

Tell them since your not taking hcg , can they give you more T. Because hcg increases t levels and your gonna need more T takes its place.


#68

I’m 2 weeks into TRT myself, very similar SHBG (64) to yours. But my E2 was in the gutter. I am doing 80mg Subq twice a week. No AI, no hCG just test cyp. Sub q in the belly with a 26g 3/8” pin is easy and painless


#69

There seems to be some who have a huge bias towards telemedicine and I understand why face to face is prefered, but the OP starting protocol that is not out of the norm for high SHBG men and calling it a cookie cutter protocol I believe is do to the fact it’s a telemedicine clinic some are against and I believe it’s causing the OP to second guess everything who has been given a protocol tailored to high SHBG men that is going to see excess androgens lower his high SHBG.

He might need more or less testosterone, but we have to start somewhere. Telemedicine is the future of medicine plain and simple.


#70

Nice. How’s it going so far?


#71

Agreed


#72

Nah, it isn’t THE future, at least not until we hook ourselves up to our computers and the internet diagnoses us and prescribes treatment.

However, I agree that it has a place and likely increasingly so. The place is also within the medical practice statutes of the state you reside in. The illegal practice of medicine is not the future of medicine.

What state are you in? Does your doctor have a license to practice medicine in your state? Did you have a face to face consultation and exam with your doctor prior to going to the telephone?


#73

but what if you go against what they say? example, my endo said no to checking e2 and i said i wanted because i suspect something and at the end she just gave it to me but in a bad mood and said” you should be an endo”…


#74

the thing is, if not defy what he would do? keep jumping from doctor to doc until he picks the right one? its like winning the lotery i mean yeah you decide what you want to do but endos are the same. you put legit info and they think you know better than them and bam! youre out. happened to me for asking hcg or why they dont measure shbg


#75

have you seem testosterone reddit? pro online clinic


#76

I am anal with Drs. As soon as I detect errors I switch doctors. I mostly see Drs affiliated with top hospitals in my area. I research each Dr. Read reviews etc. Check for lawsuits.

I ask informed questions. Drs that are good listen to you. Other say stop reading. When they say stop reading I leave their practice.

I live near NYC. No reason to be stuck with incompetent Drs

My urologist who manages my trt I found on EM forum. He’s is one of the ones with a thread on the Drs expert forum/topic

My Endo prescribed testosterone but I felt did not know how to manage. He prescribed 200 mg every 2 weeks. He agreed to 1x a week. But I then did 2x every week. In started looking for another dr and landed with that urologist. He actually sells HCG in his office gets from compound pharmacy in Florida.

He also knows of compound pharmacy in the area to get things like compounded Cialis if insurance doesn’t cover.

I finally got my mother to switch cardiologistds. She now sees my cardiologist. The one she went to made several errors with my in laws. Older people hate to switch Drs. I enjoy switching Drs to find the best.
You need to be proactive. If I ever need to go to the ER I have a Dr affiliated with a great hospital. I do not want a regular resident taking care of me.

My cardiologist actually on staff at the hospital. You go to the ER and say your Dr is so and so. You will get better care usually. That Dr immediately becomes in charge of your care and not the ER resident.

I’ll tell you why am anal with this stuff. You guys know everything else. :joy:

If I did not question the Dr my boys would not have been born. I ended up flying my wife to Florida to get placenta surgery to save my son’s.

And these assholes want to terminate a child life in the womb or even after they are born and I moved the Earth to save my unborn sons.

Drs usually dislike me but I don’t give 2 shits. Especially Drs taking care of my kids.


#77

No, I have not.


#78

This is your life. If a doc is not happy that you are educating yourself, then they are stupid and do not realize your doing half the job for them.

Docs complain: my clients won’t do their part.
Lose weight. Read up on it. Log. Whatever. Then they complain the client thinks he knows what he’s talking about.

Don’t get too negative or believe all docs are the same. They are not. It takes allot of research to find a doc that can help and listen to what you offer. These docs are open minded . How dory do you want a doc that hears you. Or do you want a doc that doesn’t need to be educated. Or a doc that you will follow without question… this is what I want. I don’t want to be the guy who has to learn it all and find out what’s wrong. I want a provider I can talk to and walk away with a solution and answers.

In the end you get what you pay for. You don’t go to an endo for hrt. You go to a doc who focused on Hrt and has the credentials (articles, authority, content, reviews , references or associations) to help. You can find a doc who charges 200 a mo and that’s what 90% of the market will pay: probably no more than 150…it’s amazing how many people will spend thousands a year on nonsense but gasp at the $$$ a year to manage their health optimally.

Finding a up to date hrt doc is as simple as getting on YouTube and hearing different trt docs talk on the subject. Form this you realize whose the boss and who is not. After a few searches on google you can quickly realize there locations and how much they charge.


#79

Defy medical will not treat you unless you have a detailed physical evaluation by a physician, there’s only five states where to Defy Medical cannot offer services do to those individual states laws, California not being one of them.


#80

You can go to a cvs and get a physical . They will use that. And lab work … that’s all… same with the other clinics I called .


#81

I don’t know anything about them, other than what is said here. I guess the doctors there must be licensed in most states if that is true.

I think a doctor treating a patient based on the examination of another practitioner, without knowing the patient or ever seeing the patient, is odd. It wouldn’t be for me.

As a patient, if you’re good with it, fine with me.